The Thai Diagnostic Autism Scale (TDAS) was developed to diagnose autism spectrum disorder (ASD) under the context and characteristics of the Thai population. Although the tool has an excellent agreement, the interpretation of diagnostic results needs to rely on the optimal cut-off point to maximize efficiency and clarity. This study aims to find an optimal cut-off point for TDAS in the diagnosis of ASD and to compare its agreement with the DSM-5 ASD criteria. This study was conducted on 156 children aged 12–48 months old who were suspected of having ASD and had enrolled from hospitals in the four regions of Thailand in 2017–2018. The optimal cut-off point for TDAS was considered by using receiver operating characteristic (ROC) curves according to the DSM-5 ASD criteria. The areas under the curve (AUCs) for TDAS and ADOS-2 were also compared. Multivariable logistic regression was performed to create a predictive model for the probability of ASD. The AUC of TDAS was significantly higher than that of ADOS-2 (0.8748 vs. 0.7993; p = 0.033). The optimal cut-off point for TDAS was ≥20 points (accuracy = 82.05%, sensitivity = 82.86%, and specificity = 80.93%). Our findings show that TDAS with a cut-off point can yield higher diagnostic accuracy than ADOS-2 and TDAS domain. Diagnosis by using this cut-off point could be useful in practical assessments.
Air pollutants, especially particulate matter (PM) ≤ 2.5 µm (PM2.5) and PM ≤ 10 µm (PM10), are a major concern in upper northern Thailand. Data from a retrospective cohort comprising 9820 lung cancer patients diagnosed from 2003 to 2018 were obtained from the Chiang Mai Cancer Registry, and used to evaluate mortality and survival rates. Cox proportional hazard models were used to identify the association between the risk of death and risk factors including gender, age, cancer stage, smoking history, alcohol-use history, calendar year of enrollment, and time-updated PM2.5, PM10, NO2 and O3 concentrations. The mortality rate was 68.2 per 100 persons per year of follow-up. In a multivariate analysis, gender, age, cancer stage, calendar year of enrollment, and time-varying residential concentration of PM2.5 were independently associated with the risk of death. The lower the annually averaged PM2.5 and PM10 concentrations, the higher the survival probability of the patient. As PM2.5 and PM10 were factors associated with a higher risk of death, lung cancer patients who are inhabitant in the area should reduce their exposure to high concentrations of PM2.5 and PM10 to increase survival rates.
The modern online society requires everyone, especially children and young people, to learn how to use the Internet. Cyberbullying is one misuse that can be detrimental to the cyberbullied individuals’ mental health and lifestyle, and it often ends up with the victim becoming depressed, fearful of society, and in the worst cases, suicidal ideation. The aim of this study is to investigate the awareness, perception, and perpetration of cyberbullying by high school students and undergraduates to find ways to prevent cyberbullying in the future. For this cross-sectional study, data were collected in 2020 from 14 schools throughout Thailand and 4 universities in Chiang Mai, Thailand, using two-stage sampling. Chi-squared tests were used to compare differences between the groups. Of the 2,683 high school students, girls perceived cyberbullying more than boys (81.6% vs. 75.4%; p <0.001), with those from the later academic years being more aware of cyberbullying (p = 0.033) and more likely to conduct cyberbullying behavior (p = 0.027). Of the 721 undergraduates, women were more aware of cyberbullying than men (92.1% vs. 82.7%; p <0.001). The most common cause of cyberbullying was aiming to tease the target (67.6% of high school students vs. 82.5% of undergraduates). The most commonly cyberbullying victimization was sending mocking or rebuking messages (29.6% of high school students and 39.6% of undergraduates). The most popular solutions for cyberbullying were to avoid leaving a trace on social media and be with friends who accept who you are. Our findings show that most of the cyberbullying perpetrators did not consider that their actions would have serious consequences and only carried out cyberbullying because of wanting to tease their victims. This is useful information for the cyberbullying solution center, teachers, and parents to recognize how to make the students realize the effects of cyberbullying on the victims.
Epilepsy often causes more severe behavioral problems in children with autism spectrum disorder (ASD) and is strongly associated with poor cognitive functioning. Interestingly, individuals with ASD without a history of epilepsy can have abnormal electroencephalographic (EEG) activity. The aim of this study was to examine associations between EEG abnormalities and the ASD severity in children. The children with ASD who enrolled at the Rajanagarindra Institute of Child Development, Thailand were included in this study. The severity of ASD was measured by interviewing their parents with the Thai autism treatment evaluation checklist. The short sensory profile checklist was used for screening the abnormality of children in each domain. Ordinal logistic regression analysis was used to examine associations between factors potentially linked to EEG abnormalities. Most of the study participants were boys (87.5%) and the median age was 5 years. Among the 128 children, 69.5% showed EEG abnormalities (41.4% slow-wave and 28.1% epileptiform-discharge). The results show that a larger number of symptoms and increased severity of ASD were independently associated with a higher risk of EEG abnormalities. Our results emphasize the need for guidelines on the presence of EEG abnormalities in children with ASD for the early detection of epilepsy and improving treatment outcomes.
Although HIV pre-exposure prophylaxis (PrEP) is free in Thailand, many transgender women discontinue taking it after initiation. We determined the loss to follow-up (LTFU) rate of transgender women who initiated PrEP at the Mplus Foundation, Chiang Mai, Thailand, and identified associated risk factors using Cox proportional hazard models. Of 235 participants who initiated PrEP, 59 (55%) out of 108 remaining participants had reactive syphilis. The LTFU rate at 6 months was 38% (95% confidence interval [CI]: 29–48%). Multivariable analysis indicates that LTFU is independently associated with age ≥ 26 years old (adjusted hazard ratio [aHR] = 2.09; 95% CI: 1.06–4.14) and reactive syphilis (aHR = 1.98; 95% CI:1.01–3.88). Delayed appointment scheduling by the PrEP providers and the syphilis clinic was associated with transgender women having reactive syphilis, and the lockdown policy during the COVID-19 pandemic might have influenced them to discontinue PrEP and their subsequent LTFU.
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